The State of Preventative Care in America

To suggest that "an apple a day keeps the doctor away" is a rudimentary approach to health care is an understatement. It may be a healthy snack, but that's about the extent of an apple's healing properties.

However, one thing can definitely have a major impact on your overall wellness: preventive health care.

If you only think about going to the doctor when you feel under the weather, though, you're not alone. Researchers say only 8% of Americans get all of the highly recommended preventive services that are most likely to improve health significantly.

So, what does preventive care in America really look like, and who's taking advantage of it? To learn more, we analyzed a 2019 report by the Centers for Disease Control and Prevention's (CDC) Behavioral Risk Factor Surveillance System (BRFSS). Keep reading to see how many people are getting routine checkups, flu shots, and HPV screenings and how often health insurance is a barrier to preventive care.

A Closer Look

You probably know that seat belts save lives, and whether out of habit or safety, 94% of Americans click in when they get into a vehicle.

However, most people aren't taking the same safeguards with their health.

Here's a brief overview of preventive care in America according to 2018 data from the CDC. While over 4 in 5 Americans had some form of health care coverage, roughly 1 in 4 didn't go to the doctor for a routine checkup in the past year. Only 2 in 3 visited the dentist in 2018. Additionally, just 1 in 3 Americans got a flu shot in the last year, and fewer than half were tested for HPV.

Meanwhile, 1 in 4 women hadn't had a pap test in over three years (despite expert recommendations to do so), and almost 2 in 5 women aged 45 and older without health insurance were overdue for a mammogram.

Taking Precautionary Measures

According to the CDC, regular health exams can identify major health concerns before they start. An apple once a day won't do much to help detect breast cancer early or prevent cardiovascular disease, but routine checkups with the right doctors can.

Nearly 1 in 4 Americans hadn't seen a doctor for a routine exam in the past year, and 12% hadn't had a regular checkup in at least two years. While around 77% said they had a routine checkup within the last year, 11% said they had gone within the past two years. Meanwhile, nearly 1% of Americans reported never having had a checkup.

Some parts of the country also had a higher likelihood of routine health screenings than others. Routine checkups in the last year were most likely in Rhode Island (84%), New York (82%), and West Virginia (81%) and least likely in Idaho (68%), Wyoming, and Colorado (69% apiece).

Access to care might be keeping people from seeing a doctor before they get sick. While 1 in 5 people with health care didn't have a routine checkup in the last year, of the 1 in 10 Americans with no health care, half didn't see a doctor for preventive care during the same time frame.

Lack of Accessibility

Americans without health insurance were over three times more likely to not see a doctor (for preventive care or otherwise) in the past 12 months. In addition to not having regular access to health care professionals, uninsured Americans were less likely to get recommended preventive screenings, including those for blood pressure, cholesterol, breast cancer, and colon cancer.

Eighty-eight percent of Americans had health care coverage, and some areas of the country had a higher population with insurance than without. According to the CDC, states with the highest percentage of residents with health insurance included Washington (94.6%), Vermont (93.7%), and Massachusetts (93.5%). In contrast, Texas (77.1%), Georgia (82.1%), and Mississippi (83.9%) had the lowest percentages.

The relationship between poverty and health care coverage in the U.S. is most evident in the percentage of Americans who've never had insurance. Compared to less than 1 in 10 people earning more than $50,000 annually who've never had health insurance, more than 1 in 5 earning less than $15,000 a year reported never having insurance.

Preventing the Flu

Between 2017 and 2018, the CDC estimated that flu shots prevented the spread of influenza for 6.2 million people, eliminating the need for 3.2 million people to see a doctor for symptoms and 91,000 people from going to the hospital. Especially among children and the elderly, flu shots save lives.

In the last 12 months, just 1 in 3 Americans had a flu shot, 17% of who had no health insurance at the time. Younger adults were less likely to get a flu shot, including roughly 20% of those aged 18 to 24 and 25 to 34 and 25% of those between the ages of 35 and 44. One report found that 61% of millennials aware of anti-vaccination theories believed them in some part, which could play a role in their willingness to get the flu shot. In contrast, more than half (51%) of Americans aged 65 and older got a flu shot in the last year.

Americans living in Washington, D.C. (44%), West Virginia (43%), and North Carolina (42%) were the most likely to get a flu shot, while those living in Texas (26%), Louisiana (26%), and New York (28%) were the least likely.

Preventing HPV

For women, cervical cancer is the fourth most occurring cancer type. According to the World Health Organization (WHO), cervical cancer cases can be significantly reduced through prevention, early diagnosis, and effective screenings. It is recommended that women get screened for HPV every three years until they turn 30 and every five years after that.

In the U.S., more than half of women (51%) had never had an HPV test, and only 16% were vaccinated for HPV. Washington, D.C. (almost 65%), Oregon (62%), and New Hampshire (55%) had the highest population percentages of HPV testees, while Utah (39%), Idaho (42%), and Nebraska (43%) had the lowest.

Keeping Our Pearly Whites Clean

Not many people really like going to the dentist, but the standard for routine cleaning is twice a year, and your dentist will almost certainly know if you're skipping sessions. Plaque buildup, cavities, and gum disease are more likely to occur among adults not participating in regular dentist visits.

According to the CDC, 1 in 3 Americans hadn't seen a dentist in the last year. Dentist visits were highest among residents living in Connecticut (nearly 77%), Hawaii (75%), and Massachusetts (74%) and lowest in Mississippi (54%), West Virginia (55%), and Arkansas (56%).

Taking Better Care of Ourselves

We take precautionary measures every day, putting on a seat belt in the car, wearing a helmet while bike riding, and wearing special gloves or goggles when working on a home improvement project – so why is it any different with preventive health care? While some parts of the country (including Washington, D.C., and West Virginia) had the highest percentages of residents getting routine checkups, other areas (including New York and Louisiana) ranked at the bottom.

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Methodology and Limitations

For this project, we tapped into the Centers for Disease Control and Prevention's (CDC) Behavioral Risk Factor Surveillance System (BRFSS), which surveys Americans via telephone on questions related to their life, and more specifically, their health and habits related to their health, for 2018 (released July 26, 2019) . The survey was conducted across all 50 states, Washington, D.C., Guam, and Puerto Rico. For this project, Guam and Puerto Rico were excluded from state rankings. In addition, "not listed," "not asked," or in cases where respondents "refused" to answers were excluded from our analysis. Data were preweighted (raked) by the CDC. Please note there are inherent issues with self-reported surveys. Issues include, but are not limited, to lying and exaggeration.

Fair Use Statement

You don't need to book a doctor's appointment to share the health findings from this study. Help spread the news about preventive care in the U.S. for any noncommercial use by including a link back to this page as credit to our team.